小剂量红霉素治疗生物膜形成相关的慢性绿脓杆菌肺部感染的临床研究  

Effects of low-dose erythromycin treating the biofilm form associated chronic pulmonary infection originated from pseudomonas aeruginosa

作　　者：莫诚航[1] 尚为民[1] 邝敏[1] 陆芸芸[1] 黎冬梅[1] 陈一强[2] 

机构地区：[1]广西医科大学第三附属医院呼吸科,广西南宁530031 [2]广西医科大学第一附属医院呼吸科

出　　处：《中国现代医药杂志》2006年第10期1-3,共3页Modern Medicine Journal of China

基　　金：广西南宁市科技局科技基金资助项目(No.20020340C)

摘　　要：目的评价长期应用小剂量红霉素治疗生物膜形成相关的慢性绿脓杆菌肺部感染的临床疗效。方法选择40例稳定期慢性阻塞性肺疾病(COPD)合并慢性绿脓杆菌肺部感染患者,随机分为治疗组和对照组,每组20例,其中治疗组是在基础治疗的基础上加用口服红霉素125mg,3次/天;对照组仅用基础治疗。基础治疗包括:吸氧,允许使用稳定剂量的茶碱、口服或吸入支气管扩张剂,但不允许使用其它大环内酯类药和激素。两组疗程均为3个月。结果3个月治疗结束后观察痰细菌清除率情况:治疗组细菌清除率60%(12/20),对照组20%(4/20),两组相比差异显著(P<0.05)。治疗组肺功能(FEV1):治疗前(0.69±0.13)L,治疗后(0.83±0.18)L;生活质量评分情况:治疗前47.6±5.13,治疗后33.8±4.89,较对照组有明显改善(P均<0.05)。结论长期应用小剂量红霉素可抑制和破坏绿脓杆菌形成的生物膜,有利于绿脓杆菌的清除,并能改善稳定期COPD合并慢性绿脓杆菌肺部感染患者的肺功能和生活质量。Objective To evaluate the clinical efficacy of low-dose long-term erythromycin treating the biofilm form associated chronic pulmonary infection originated from pseudomonas aeruginosa. Methods A prospective double-blind controlled trial randomized 40 patients with stable COPD with chronic pulmonary infection colonized by pseudomonas aeruginosa to trial group （20 patients） or control group （20 patients）. The basic treatments included oxygen therapy, therapy with theocin in safe dose, therapy with inhaled or oral bronchodilators were involved in both groups, 3 months＇ therapy with oral erythromycin 125mg three times daily in the trial group; only basic treatments were involved in the control group, time of therapy was also 3 monthes. Corticosteroid could not be involved in either group. Bacterial clearance of sputum, FEV1, improvements in symptom scores were determined at the end of therapy. Results The bacterial clearance of sputum was 60% （12/20） in the trial group and 20% （4/20） in the control group. There was statistically significant between two groups（P〈0.05）. The average FEV 1 of trial group was （0.69～0.13 ） L before treatment with erythromycin, （0.83～0.18） L after treatment; Improvements in symptom scores was 47.6～5.13 before treatment, 33.8～4.89 after treatment with erythromycin in the trial group, had significant improvement than the control group. Conclusion Therapy with low-dose long-term Erythromycin can inhibit and destroy the biofilm of pseudomonas aeruginosa, be benefit to the pathogen eradication, and improve the pulmonary function and quality of life.

关 键 词：红霉素 绿脓杆菌 生物膜 慢性阻塞性肺疾病 

分 类 号：R516[医药卫生—内科学]